川芎嗪对糖尿病大鼠骨质疏松的保护作用

探讨川芎嗪对糖尿病大鼠骨质疏松的保护作用.选择健康SD大鼠,随机分为正常对照组、糖尿病(DM)模型组和治疗组.一次性腹腔注射链脲佐菌素60mg/kg诱发糖尿病.HE染色观察股骨头结构变化;VanGieson氏染色法观察骨胶原纤维;紫外分光光度法测定醛糖还原酶(AR)、骨羟脯氨酸(B-HYP)和甲状旁腺激素(PTH)的含量.结果,DM模型组大鼠AR和PTH含量显著增高(P<0.01).B-HYP含量显著降低(P<0.01).胶原纤维减少,川芎嗪可逆转上述改变(P<0.01).结果表明,川芎嗪对糖尿病大鼠骨质疏松有一定的治疗作用.     

Effect of antihypertensive drugs on cardiac enzymes in hypertension with myocardial infarction in NIDDM

Enzymology is a diagnostic indicator for myocardial infarction and diabetes in hypertension patients. Therefore the selection of methods for measurement of cardiac enzyme, Aspartate transaminase (AST), Creatine kinase(CK), and isoenzyme of creatine kinase (MB form), determine the effectiveness of antihypertension drug would provide the physician with diagnostic and prognostic clinical evidence.     

Study of lipid peroxide and lipid profile in diabetes mellitus

The study was designed to find out the correlation between lipid peroxidation, lipoprotein levels to severity and complication of diabetes mellitus. Degree of lipid peroxidation was measured in terms of malondialdehyde (MDA) along with lipid profile and blood glucose in diabetes mellitus. It is categorised into insulin dependent diabetes mellitus (IDDM), non insulin dependent diabetes mellitus (NIDDM) and diabetes mellitus(DM) with complication. Total 112 known diabetic patients and 52 non-diabetic controls were studied. These patients were grouped as per the concentration of fasting blood glucose level i.e. controlled, poorly controlled, and uncontrolled group. There are significant increase in the lipid peroxide (MDA) and lipid profile except HDL cholesterol which is decreased, has been found in all groups as compared to controls In NIDDM group lipid peroxidation was markedly increased than IDDM group and it was higher in DM with complications. Other finding observed was that the level of lipid peroxide increased as per the increase in concentration of blood glucose. The increase lipid peroxidation in the hyperglycemic condition may be explained, as the superoxide dismutase enzyme which is antioxidant becomes inactive due the formation of superoxide radical within the cell. Maximum lipid peroxidation leads to the damage of the tissue and organs which results into complication in diabetic patients. High levels of total cholesterol appear due to increased cholesterol synthesis. The triglyceride levels changes according to the glycemic, control. The increase may be due to overproduction of VLDL-TG. It is concluded that good metabolic control of hyperglycemia will prevent in alteration in peroxidation and the lipid metabolism, which may help in good prognosis and preventing manifestation of vascular and secondary complication in diabetes mellitus.     

Paired values of serum fructosamine and blood glucose for the screening of gestational diabetes mellitus: A retrospective study of 165 Saudi pregnant women

This study reports the utilization of serum fructosamine and blood glucose for the screening of gestational diabetes mellitus (GDM). Blood samples from 165 pregnant women were analyzed for fasting blood glucose (FBG), random blood glucose (RBG) and serum fructosamine. The actual fructosamine levels were corrected for serum protein (c-Fruct) for more precise presentation. Two cut-off values of FBG (>5.3 mmol/L and >7.0 mmol/L) and RBG (>7.8 mmol/L and >11.0 mmol/L) were used to classify hyperglycemic subjects for subsequent evaluation. The average values±standard deviations for FBG, RBG and cFruct were 5.865±1.95, 7.767±3.21 and 2.387±0.47 mmol/L, respectively. FBG levels were significantly correlated with RBG (Pearson correlation=0.597, P<0.001). Significant correlations were also observed between cFruct and FBG (Pearson correlation=0.673, P<0.001) or RBG (Pearson correlation=0.641, P<0.001). Out of 165 subjects, 24 (14.5%) cases were classified as hyperglycemic on the basis of FBG>7.0 mmol/L or RBG>11.0 mmol/L; use of lower cut-off values resulted higher frequencies of hyperglycemia. Whereas, a combined criteria of FBG>5.3 mmol/L and cFruct >2.5 mmol/L predicted 35 patients as the most probable hyperglycemic as compared to 32 patients identified using the criteria of RBG >7.8 mmol/L and cFruct >2.5 mmol/L. These criteria were associated with 4.8% and 3.6% false-positivity at the expense of 3.6% and 3.0% false-negative outcomes, respectively. The levels of FBG, RBG and cFruct were significantly higher in hyperglycemic groups (irrespective of grouping criteria) as compared to the respective normal groups. In conclusion, these findings clearly indicate that the paired values of cFruct with FBG or RBG could help in filtering high-risk individuals for OGTT and therefore avoiding a unnecessary OGTT.     

Association of Type II 5′ Monodeiodinase Thr92Ala Single Nucleotide Gene Polymorphism and Circulating Thyroid Hormones Among Type 2 Diabetes Mellitus Patients

Diabetes mellitus and thyroid disorders are common endocrinopathies, which often occur parallel. Dyslipidemia is very common in both of these conditions. The development of hypothyroidism is well-known in type 1 diabetics, but it was not distinctly understood in type 2 diabetics. Thus we tried to examine the association between type II deiodinase (D2 or DIO2) Thr92Ala single nucleotide gene polymorphism and thyroid function among type 2 diabetes mellitus patients. A total of 130 type 2 diabetics were screened and genotyped for DIO2 Thr92Ala polymorphism. Fasting plasma glucose, Glycosylated haemoglobin, lipid and thyroid profiles, malondialdehyde (MDA) and paraoxonase were estimated according to standard procedures. A significant altered level of thyroid hormones (TH’s) was found in Ala/Ala genotype when compared with Thr/Thr or Thr/Ala genotype. DIO2 and T₃:T₄ ratio significantly decreased, whereas total T₄ and thyroid stimulating hormone levels significantly elevated among Ala/Ala genotype (131 ± 30 ng/ml; 0.12 ± 0.05; 7.17 ± 2.05 µg/dl; 4.77 ± 3.1 µIU/ml, respectively) when compared with Thr/Thr + Thr/Ala genotypes (176 ± 33 ng/ml; 0.21 ± 0.05; 5.21 ± 1.1 µg/dl; 2.59 ± 1.61 µIU/ml respectively). Moreover, D2 levels were significantly negatively correlated with TH’s levels except total T₄ among Ala/Ala genotypes. All the patients were having a poor glycemic control, and their glycemic status was positively correlating with MDA levels. On the other hand, serum paraoxonase activity decreased among Ala/Ala genotype (104 ± 21 vs. 118 ± 18 nmol/min/ml). In conclusion, DIO2 Ala92 homozygous variant found to be associated with altered levels of DIO2, Thyroid profile and paraoxonase. Hence, we recommend to do detail study of genetic factors related to thyroid function and prevent additional diabetic complications.     

Additive Effect of Lipid Lowering Drug (Simvastatin) in Combination with Antidiabetic Drug (Glibenclamide) on Alloxan Induced Diabetic Rats with Long Term Dyslipidemia

High blood glucose level, elevated level of liver enzyme, necrosis and shrinkage of islets of Langerhans has been implicated in the pathogenesis of type 2 diabetes. High blood glucose cause oxidative stress, production of free radical as well as elevated SGPT and SGOT level. Both glibenclamide and simvastatin in fixed dose used as antihyperglycemic antidyslipidemic and antioxidative agents for type 2 diabetes treatment. This study therefore aimed to evaluate the antihyperglycemic, antidyslipidemic and antioxidative effect of fixed dose combination of glibenclamide (0.6 mg/70 kg body weight) and simvastatin (5 mg/70 kg body weight) on long term alloxan induced diabetic rats with cardiovascular disease using various diagnostic kits as a parameter of phamacotherapeutic and pharmacological effect. The study was carried out using 96 Swiss Albino male rats weighing about 200–220 g. Combination therapy induced a significant decrease in blood glucose level in alloxan induced diabetic rats, from 33.75 ± 1.65 to 5.80 ± 0.07 mmol/l 2 h after last dose administration, after 4 weeks treatment. In case of dyslipidemic effect, combination therapy reduced total cholesterol (45 %), triglyceride (36 %) and low density lipoprotein-cholesterol (32 %) levels significantly and increased high density lipoprotein-cholesterol level (57 %) in comparison with their respective diabetic control groups. Results of this study showed that combination therapy effectively decreased SGPT (ALAT) (55 %) and SGOT (ASAT) (51 %) in comparison with diabetic control group. It was also observed that catalase and superoxide dismutase enzyme activity was increased by 58 and 91 % respectively in comparison with diabetic control group after 4 weeks treatment with combination of both drugs. In conclusion, these findings of combination therapy (glibenclamide and simvastatin) on alloxan induced diabetes in rats are significantly better than monotherapy using single drug. The results of the present study suggest that, combination of the fixed dose of glibenclamide and simvastatin might be efficacious in patients with diabetic dyslipidemia and increased oxidative stress. Furthermore, this combination therapy offer dosage convenience to the patients and by virtue of its dual mode of action might be a useful addition to the therapeutic armamentarium for patients with diabetic dyslipidemia and oxidative stress.     

Basal or bolus dose, which is the key factor in CSII？

Objective： To observe the value of HbA1c level evaluating the total daily basal insulin dose by continuous subcutaneous insulin infusion （CSII） in 268 patients with type 2 diabetes mellitus, Methods： 5-point capillary blood glucose was monitored in pre- and post-CSII and the insulin dose which could stabilize blood glucose was defined as the total daily dose of insulin, including basal and bolus total dose. Correlation between HbA1c level and total daily dose of insulin in patients with type 2 diabetes mellitus was analyzed. Correlation between HbA1c level and 5-point capillary blood glucose was also analyzed. Results： Obvious correlation was observed between HbA1c level and the basal total daily dose of insulin if HbA1c was more than 9.3% （r=0.635, P〈0.05）. The average of 5-point capillary blood glucose was best correlated with HbA1c and fasting blood glucose next best. Conclusion： HbA1c level can forecast basal total daily dose of insulin in CSII.     

体力活动不足、久坐行为与糖代谢异常检出率的关系

目的：探讨体力活动（PA）不足和久坐行为（SB）与糖代谢异常检出率的关系。方法：对30~69岁具有至少3项DM危险因素者进行糖耐量筛查,采用国际体力活动问卷（IPAQ-SF）调查PA水平和SB,并利用加速度计对问卷进行效度检验。结果：研究纳入195人,平均年龄（51.92±10.64）岁。糖代谢异常检出率为67.18%,检出率随DM危险因素数量的增多而升高。IPAQ-SF中MPA、MVPA以及SB时间与加速度计测量结果的相关系数r分别为0.35、0.37和0.43。受试者中75.9%属于PA不足,同时具有"PA不足+（年龄≥ 40岁）+超重/肥胖"三项的受试者最多（48.21%）。在调整了混杂因素之后,与SB ≤ 6h/d组相比,SB>6h/d组受试者的糖耐量异常检出率更高（OR=2.37,95% CI：1.12~5.02）。结论：多种DM危险因素聚集者中糖代谢异常检出率较高,PA不足者较多,SB增加糖代谢异常风险,IPAQ-SF适用于对该人群进行PA评价。建议对糖尿病多危险因素聚集者,尤其是PA不足、SB较多、超重/肥胖者及时筛查并重点关注,降低糖代谢异常发病率。     

2型糖尿病大鼠基因表达变化的研究

研究2型糖尿病大鼠和正常大鼠肾脏组织差异表达基因,筛选与糖尿病相关的基因。应用基因芯片技术对糖尿病和正常大鼠的肾脏组织的mRNA进行检测。在4096条目的基因中共发现差异基因41条（其中5个基因上调,36个基因下调）,全部在GeneBank中登录。2型糖尿病的发生、发展涉及多基因改变,用基因芯片在寻找新的2型糖尿病相关基因方面有极大的应用前景,对于糖尿病的诊断,治疗和预防具有一定的临床应用前景。